Pain management in labour and childbirth
This article covers the following topics:
Giving birth is a natural process and even if you haven’t spent the past nine months reading medical textbooks, your body and your baby know exactly what to do. That’s why - although your baby isn’t ticking off the days on a calendar - he can tell when it’s time to be born.
When that day arrives, your baby sends a signal – the hormone, oxytocin - across the placenta that triggers contractions and keeps them coming. Alongside oxytocin, another substance, prostaglandin, gets to work, softening the neck of the womb (the cervix) so it can open up (dilate) to allow your body to know how to make labour happen.
Your body also knows you need to cope with pain so it produces its own painkiller. Endorphins not only limit pain but lower stress and have a feel good factor too. The pain of labour, however, has a very important function, giving you important clues about ways of moving and positions that may help your baby turn and move down inside the pelvis. It can also let you know how your labour is progressing.
Labour is complex but you just need to let your body do what comes naturally. Unfortunately, fear can affect this amazing process.
Fear makes you release another hormone altogether – adrenaline – which slows down the production of oxytocin and prepares your body to fight or run away (not helpful when you’re trying to give birth). In this state of tension and alertness, your contractions are less efficient and you focus on the pain and feel worse. Staying calm is therefore the key to coping with pain.
To help you feel relaxed, read up on what happens during labour, choose a place to give birth where you feel safe, and have a birth partner you know and trust. Research has show that it is important for women in labour to have emotional support. This means encouragement, reassurance, a trusted person to listen to you and just be there.
For some women, this will be their partner, for others it will be a friend or close family member. Some women might also choose a doula, a woman who will provide one-to-one support for parents from late pregnancy, through labour, birth, and into the first hours and weeks with their new baby.
Making sure that you have the right person to support you will help you cope with the pain and discomfort of labour more easily.
Attending antenatal classes is also a really useful way of preparing for labour and gaining an understanding of what will happen on the day.
Labour can last a long time so, at the beginning, try movement, upright positions, massage and water to help you cope. If you head straight for maximum pain relief, you’ll never know how other things can help – plus your labour may end up being even longer. If you do feel you can’t cope, you can move through the different pain relief options.
If it feels really tough, ask your midwife how you are getting on. Positive encouragement – knowing you are coping really well and making good progress – can make all the difference.
The following tips have been found useful by women in labour:
- Before labour, spend some time imagining after the birth with your new baby in your arms and that all is well. Imagining that you did it, and that you did it as you wanted, creates a positive picture to focus on.
- Moving about helps labour to progress and women have said they were better able to work with the pain while rocking and leaning forwards (the pressure of the baby’s head on the cervix will promote the release of oxytocin as well as endorphins - the body’s natural pain relievers). Focus on letting go and relaxing any muscles that aren’t needed to hold you in a position.
- Focus on the out breath during a contraction. Keep the breathing calm and rhythmic.
- Make a noise if you want to – be somewhere with people that are happy for you to moan, grunt, sigh or even swear if that helps.
- Belly-dancing, hip-wriggling and stepping movements all help your baby settle into a good position to be born.
- Massage or pressure on the lower part of your back just above the top of your bottom can help.
- Water helps women relax and move more easily; being in a pool can give women a feeling of safety and security.
- Positive, affirmative thoughts and supportive comments from birth partners help to promote confidence in the process. ‘You are doing well – your body is made for this – feel the power of your body – your body knows how to do this - each pain is progress’ are all positive and encouraging statements.
- During labour, think about welcoming each contraction. As your contractions become stronger, longer and closer together your body is getting ready to give birth.
- Rest, relax and conserve energy between contractions as labour progresses.
- Have confidence in your own self-help resources.
- Acknowledge that labour is unpredictable and that uncertainty is difficult to go along with. Try to go with the flow.
Recognising the point at which labour feels worst – when you have had enough - is often the point just before you are ready to start pushing your baby out. Having people with you who help you feel strong and capable can make all the difference.
Most importantly, you need to feel confident that you can do this so try to listen to your body and not let fear or anxiety overwhelm you.
NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700. We also offer antenatal courses which are a great way to find out more about birth and life with a new baby.
Dads who are birth partners might find our online guides for them useful.
NCT offers a service called NCT Doula, providing one-to-one support for parents from late pregnancy, through birth, and into the first hours and weeks with their new baby. They provide women, and their partners, with skilled physical and emotional assistance, as well as up-to-date knowledge, information and encouragement to help them have the type of birth they would most like. NCT Doulas are all qualified professionals who have completed a nine-month course, developed by NCT in partnership with the University of Worcester. This is a Recognised Doula UK course.
NHS Choices guide to pain relief in labour.